March 2015

One of the advantages of using electronic health records is the amount of information they place at doctors' fingertips, enabling them (in theory) to provide the highest level of care for their patients.

You see a 29-year-old female insurance saleswoman with a 6-week history of joint pains and swelling affecting both hands and wrists, both feet and her left knee. Her symptoms are worse when she first gets up in the morning and it takes a few hours before her joints seem to loosen up.

Viewers have plenty of choices when it comes to medical talk shows on television. With all their recommendations a recent study looked at whether they are doing more harm than good to the potential patient pool.

Is orally administered morphine superior to ibuprofen for outpatient pain management for children with uncomplicated fractures?

For some patients the first treatment they receive to help manage their pain is opioid medication. Recent studies have looked at whether staying on these prescriptions for long periods of time can do more harm than good.

For patients dealing with chronic pain, the issues of their overall care can go beyond the body and into their minds. Addressing both areas can be key to helping them have normal everyday lives.

A 28-year old man comes in who recently arrived in southern California from South America and suddenly developed a "cold." His symptoms included productive cough, shortness of breath, chest pain, fever, weakness and malaise. He also reported unexplained weight loss. Sputum and blood specimens were obtained for acid-fast smear examination and culture. A single posterior-anterior chest radiograph was obtained as part of his initial evaluation.

A 75-year-old woman with a history of coronary artery disease, hypertension and hyperlipidemia presents with shortness of breath with exertion.

This 29-year-old man came in for a wellness evaluation but notes having had this rash for 8 years. Occasionally it itches, but otherwise is asymptomatic and he has had no treatment for it to date. He does not take any medications and has no significant past medical history.

Dietary sodium restriction is frequently recommended as a means to manage hypertension, congestive heart failure and cardiovascular disease. However, with the growing focus on patient-centered outcomes rather than disease-centered outcomes, the importance of sodium restriction becomes less clear.

Although the obesity epidemic in the United States seems to have reached a plateau over the past few years, the prevalence of obesity continues to be high with 30% of Americans classified as obese, defined as having a BMI of 30 kg/m2 or more, and an additional 30% overweight, with a BMI of 25 to 29.9 kg/m2.